The United States has finalized its withdrawal from the World Health Organization, ending America’s 78-year commitment to the global health agency one year after President Donald Trump announced the decision, federal officials said Thursday. The U.S. owes about $280 million to the organization, and the administration acknowledged it has not yet worked out how the country will access critical data from other countries that could provide early warning of new pandemics.
The withdrawal marks a significant shift in American global health policy that public health experts say will cripple the U.S. ability to develop new vaccines, respond to disease outbreaks, and access the disease surveillance information that has historically given American scientists and companies an advantage in preparing for emerging health threats.
The WHO and U.S. involvement
The World Health Organization is the United Nations’ specialized health agency mandated to coordinate the response to global health threats such as outbreaks of mpox, Ebola and polio. It provides technical assistance to poorer countries, helps distribute scarce vaccines, supplies and treatments, and sets guidelines for hundreds of health conditions, including mental health and cancer. Nearly every country in the world is a member.
The U.S. helped lead the WHO’s creation and has long been among the organization’s biggest donors. The U.S. pays on average $111 million a year in member dues to the WHO and roughly $570 million more in annual voluntary contributions, according to the U.S. Department of Health and Human Services.
Trump’s rationale for withdrawal
In an executive order issued after taking office, Trump said the U.S. was withdrawing from WHO due to the organization’s mishandling of the COVID-19 pandemic and other global health crises. He also cited the agency’s “failure to adopt urgently needed reforms” and its “inability to demonstrate independence from the inappropriate political influence of WHO member states.”
The WHO made costly mistakes during the pandemic, including at one point advising people against wearing masks and asserting that COVID-19 was not airborne, a stance it did not officially reverse until 2024.
Administration officials also noted that none of the WHO’s nine chief executives since 1948 have been Americans, despite how much the organization relies on U.S. financial contributions and personnel from the U.S. Centers for Disease Control and Prevention.
Expert concerns
Lawrence Gostin, a public health law expert at Georgetown University, called the withdrawal “the most ruinous presidential decision in my lifetime.” Public health experts say the U.S. exit will cripple numerous global health initiatives, including the effort to eradicate polio, maternal and child health programs, and research to identify new viral threats.
Dr. Ronald Nahass, president of the Infectious Diseases Society of America, called the U.S. withdrawal “shortsighted and misguided” and “scientifically reckless.”
The U.S. has ceased official participation in WHO-sponsored committees, leadership bodies, governance structures, and technical working groups. That includes the WHO group that assesses which flu strains are circulating and makes critical decisions about updating flu shots each year, and the global flu information-sharing network that guides vaccine decisions.
Such disease intelligence has historically helped Americans be “at the front of the line” when new outbreaks occur and new vaccines and medicines are quickly needed, Gostin said.
Seeking alternative arrangements
Trump administration officials say they already have public health relationships with many countries and are working to ensure direct sharing of disease information rather than having WHO serve as a middleman. But U.S. officials did not give specifics about how many such arrangements are in place.
Gostin said it is unlikely the U.S. will reach agreements with more than a couple dozen countries. “Many emerging viruses are first spotted in China,” he said. “Is China going to sign a contract with the United States? Are countries in Africa going to do it? Are the countries Trump has slapped with a huge tariff going to send us their data? The claim is almost laughable.”
The payment question
The U.S. is legally required to give notice one year in advance of withdrawal—which it did—but also to pay any outstanding financial obligations. The U.S. has not paid any of its dues for 2024 and 2025, leaving a balance of about $280 million at current exchange rates, according to WHO.
A Trump administration official denied that requirement Thursday, saying the U.S. had no obligation to pay prior to withdrawing as a member.
Gostin also said Trump may have overstepped his authority in withdrawing from the WHO. The U.S. joined the organization through an act of Congress, Gostin said, and withdrawal was supposed to require an act of Congress as well.